Prepartions - The ACL Reconstruction Surgery

You can read a lot about these in the internet and from your doctor -

• How the surgery is performed
• What precautions to take
• How long to stay in the hospital
• When you can start walking

I am no expert to give any more information than what you can research on. But there are a few points that are must-do which may or may not be adviced to you. I'm not too sure about the advices you would get in other countries, but I'm pretty sure that some of these are missed out for a common man undergoing this from a medium class hospital in India.

1. The reconstruction surgery is only 50% cure. Remaining 50% comes from your physio excercises that you would do for 9 - 12 months after the surgery
2. Have a good chat with your doctor - I may sound too obvious here, but it is important to understand a bit on the whole rehab procedure where surgery is the main part. There is nothing wrong in asking questions. Yes, Doctors are considered next to God in our culture. Still keep asking questions and get comfortable with the whole procedure
3. Ensure that someone close to you is around to take care of you for first 6 weeks. Yes - you'd need your spouse / parents / siblings to support you both physically and psychologically
4. Know your physio - Remember that 50% of your cure is going to be through physio excercises. Know what you'd do on the first day, the first week, first month and subsequent periods. It is good to mentally practice your life style to avoid any mental shock

Mental shock? Why that? We'll talk about that in the next post.

Side note: The link http://www.arthroscopy.com/sp05018.htm has good information to start with. Here it talks about Pateller tendon to be grafted for ACL reconstruction.

My doctor grafted a few strands from my hamstring and used it for ACL reconstruction. This is a newer method. You can read more about this method in http://orthopedics.about.com/cs/aclrepain/a/aclgrafts.htm. There are pros and cons for both methods.

Flash back exactly four months back - Mid Dec 2007

On that fateful sports event day on my office, I was in high in my energy. Any smart person like you would've guessed that my adrenalin levels didn't match my age and the strength levels of my knees. Though I pride myself with having a fairly strong quads and hamstrings due to recent exercises and aerobics sessions, the strength of my knee ligament was no match for the level of strain they felt when I twisted my knees sideways trying to throw a shotput. Yes, a logical person would say that the knee joint allows movement in 2D for forward and backward. I happened to twist it sideways and it immediately buckled. I could get back to my balance only by the strength of my other leg.

I managed to get back my balance on my left knee and I felt smart that I could sense that specific movement that causes buckling of my knees then on. But so smart I am, I didn't bother to check for swelling and I didn't bother to return home immediately and apply ice. Instead, I let my pride stay up and played for some more time before decided to go home 2 kms away on my motorbike.

Too many mistakes and I didn't bother to take care of my knees for a few weeks from then. A vacation trip to heavenly Andaman (I'll refrain from digressing there right now) and a trip outside the country ensured that I didn't visit the doctor for full 6 weeks from the day I was injured.

6 weeks from then, I realized that I could drive around, walk around, climb stairs, but there was always this big discomfort and the occasional buckling of my knees.

A few doctor visits and an MRI scan confirmed that my ACL is completely torn. They say I should've felt a pop sound when I got myself injured. May be it was, may be I didn't. But what scared me was the 6 weeks rest that the doctors adviced me to take. But worried me was that I had to undergo an arthroscopic surgery and be at bed rest for a while, which was unimaginable for me.

So what is this ACL reconstruction surgery is about, in Chennai condition? Will talk about that next.

Rehabilitation in India after ACL Reconstruction

Today, the 20th March 2008
It is the 7th week of my recuperation after an ACL reconstruction arthroscopic surgery in Chennai and I wanted to share some of my experiences that are more India specific here.

As they say in statistics, this is among the most successful surgery on knee with less than 0.1% chances of failure. There are quite a few useful ACL surgery and post-surgery related contents in the web that are mainly US/Europe centric. Here is something that I feel is more India-ish, if one could say that.

I am neither a doctor, nor a physiotherapist. I'm no authorized medical person. I have been a patient who underwent this and would like to share some of the good and bad things as I went through this ACL reconstruction procedure

What is this ACL
If you have not heard of ACL so far, consider that it is for good. Ligament, as Wikipedia puts it, is a fibrous semi-elastic tissue that connects one bone to another bone, typically around a joint. The anterior cruciate ligament (or ACL) is one of the four major ligaments of the knee. It connects from the back side of the bottom part of the thigh bone with the upper part of one of the leg bone below the knee. You can google and find out more on this if you want. I'll capture only some details related to some of my experience that I feel others can relate and learn if they are unfortunate to get to tear off their ACL.

Flash back exactly four months back - Mid Dec 2007

... more on it later.